A longitudinal analysis of the effect of nonmedical exemption law and vaccine uptake on vaccine-targeted disease rates

Y.T. Yang and V. Debold

American Journal of Public Health, 2014, vol. 104, issue 2, 371-377

Abstract: Objectives. We assessed how nonmedical exemption (NME) laws and annual uptake of vaccines required for school or daycare entry affect annual incidence rates for 5 vaccine-targeted diseases: pertussis, measles, mumps, Haemophilus influenzae type B, and hepatitis B. Methods. We employed longitudinal mixed-effects models to examine 2001- 2008 vaccine-targeted disease data obtained from the National Notifiable Disease Surveillance System. Key explanatory variables were state-level vaccine-specific uptake rates from the National Immunization Survey and a state NME law restrictiveness level. Results. NME law restrictiveness and vaccine uptake were not associated with disease incidence rate for hepatitis B, Haemophilus influenzae type B, measles, or mumps. Pertussis incidence rate, however, was negatively associated with NME law restrictiveness (b = -0.20; P = .03) and diphtheria-pertussis-tetanus vaccine uptake (b = -0.01; P = .05). Conclusions. State NME laws and vaccine uptake rates did not appear to influence lower-incidence diseases but may influence reported disease rates for higher-incidence diseases. If all states increased their NME law restrictiveness by 1 level and diphtheria-pertussis-tetanus uptake by 1%, national annual pertussis cases could decrease by 1.14% (171 cases) and 0.04% (5 cases), respectively.

Keywords: Haemophilus vaccine; virus vaccine, article; government; government regulation; Haemophilus infection; Haemophilus influenzae type b; hepatitis B; human; incidence; measles; mumps; pertussis; virus infection, Government Regulation; Haemophilus Infections; Haemophilus influenzae type b; Haemophilus Vaccines; Hepatitis B; Humans; Incidence; Measles; Mumps; State Government; Viral Vaccines; Virus Diseases; Whooping Cough (search for similar items in EconPapers)
Date: 2014
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Citations: View citations in EconPapers (2)

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Persistent link: https://EconPapers.repec.org/RePEc:aph:ajpbhl:10.2105/ajph.2013.301538_8

DOI: 10.2105/AJPH.2013.301538

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